The University of Tennessee Medical Center

Michael Saad

At the beginning of the COVID pandemic, hospitals and health systems around the country scrambled to implement or bolster their telehealth platform to continue providing care to their patients. Seemingly overnight, a significant number of non-emergent patient visits shifted from in-person to remote. This resulted in millions of virtual visits in the past 24 months and changed the way that patients and providers interacted with each other.

Now that we entered a new phase of the pandemic, driven by vaccines and a better understanding of how to live with the virus, what is next for telehealth? Was it merely a tool to deliver care during the pandemic, or has it ushered in a new era of how patients interact with their providers?

I believe that telehealth will continue to be a vital solution to deliver care, but I also see the potential for telehealth to continue to grow and expand. Therefore, I want to focus on two areas that will continue to benefit from telehealth and see increased growth now and in the future.

Behavioral Health

There is a significant shortage of trained mental health professionals in the United States. Over half of the counties in the United States do not have a psychiatrist, and the ones that do often do not have enough to keep up with the demand. Telehealth can help bridge this gap by connecting patients with mental health experts across the country.

According to a recent study by the Department of Health and Human Services, behavioral health accounted for nearly one-third of all telehealth visits in 2020. It also saw a 32-fold increase in the total number of visits throughout the first year of the pandemic.

AmWell published survey data showing that 62percent of patients prefer virtual telehealth instead of in-person visits. While convenience certainly plays a role in this, data shows that most people prefer to discuss behavioral health issues from the privacy and comfort of their own homes. This trend is being seen across all age groups, evidenced by Gen Z accounting for 14percent of all behavioral healthvisits and an increase of 16percent by the Baby Boomer generation.

Based on recent medical claims data, Behavioral telehealth is seeing impressive growth of 6,500percent over last year, accounting for over 1 million visits per month.

Another factor that shows how much potential Behavioral telehealth has, is the amount of venture capital money invested into this space. In 2021, over $6.9 Billion was invested in U.S.-based behavioral health companies. That number was almost three times the amount invested in 2019. In addition, consumer demand and record investments in behavioral telehealth continue to drive growth in this area.

Improved Access to Care Many factors determine access to healthcare. For those in rural communities, this can mean access to healthcare services that are not available in their area. For urban areas, access challenges can be driven by socio-economic status and include barriers such as transportation challenges and lack of insurance. Finally, this can mean access to a provider outside of regular business hours for working parents.

“Telehealth has become a standard of care for many providers and patients.”

Access to rural health continues to be a challenge for many. As more rural hospitals continue to close, mainly due to financial pressures, the gap in care continues to widen. As of 2020, nearly 57 million Americans lived in rural areas. According to the National Rural Health Association statistics, the ratio of patients to primary care physicians is 39.8 per every 100,000 in rural areas compared with 52.3 physicians per 100,000 people in urban areas. In addition, patients tend to be poorer, have greater tobacco use, and suffer from diseases such as diabetes and coronary heart disease than those in urban areas.

Telehealth can help address these disparities in care by allowing patients on-demand access to care. This alleviates some of the challenges with primary care, but this can also help close the gap with specialty care access. Patients can either have a telehealth appointment directly with their specialist or travel to a local primary care office to have a more extensive exam via telehealth. When a patient travels to a local primary care office, that office can utilize clinical instruments that the specialist on the other end of the telehealth call can use to see and diagnose the patient. This is especially important when a specialist appointment requires the use of clinical instruments such as pocket ultrasounds, otoscopes, stethoscopes, etc.

In urban areas where access to healthcare can be challenging for school-age children due to several factors, local schools partner with health systems to provide telehealth appointments. Upon parental consent, these visits can be done in the school nurse's office and connect the student and nurse directly with a qualified provider. In other cases, health systems provide low-income patients with the tools necessary to perform telehealth appointments from home. Some of these telehealth kits are provided to families to help connect them directly with their care provider when appointments are needed.

The adoption and utilization of telehealth appointments increased rapidly during the height of the pandemic. As a result, telehealth has become a standard of care for many providers and patients. Behavioral health telehealth appointments are poised to continue to leverage this vital care tool and help address the growing mental health needs across the country. Additionally, as access to care remains a focus for many in this country, telehealth can be leveraged to help overcome these barriers. Telehealth can help close the gap in care access for those in both rural and urban settings.